There are now programs that can stop and reverse the progression of Alzheimer’s disease. What can we learn about how to prevent the disease from these programs? 

Dr. Heather Sandison is the founder and medical director of North County natural medicine, and the founder of Marama. Marama provides the space, food, staff, amenities, and experience to implement the lifestyle changes necessary for Alzheimr’s patients to return to independent living. Dr. Sandison has been trained to specifically address imbalances that affect the brain including autism, depression, anxiety and Alzheimer’s. She has trained with Dr. Dale Bredesen, Dr. Neil Nathan,  and Dr. Richie Shoemaker. She earned her naturopathic doctorate at Bestir University in Seattle, Washington. She currently serves on the Medical Advisory Board of the Neuro Hacker Collective and as a regular host of the Collective Insights Podcast.

Heather Sandison  1:55   Education and early experiences

Heather Sandison  6:54  Overall view of Alzheimer’s disease 

Heather Sandison  17:27  Challenges to drug therapy for Alzheimer’s disease

Heather Sandison  22:16  Cognitive impairment as a late finding in Alzheimer’s disease

Heather Sandison  23:49  Clinical trial to evaluate response of patients

Heather Sandison  28:13  Patient experience at Marama

Heather Sandison  31:13  Prevention strategies

Heather Sandison  37:47  Education for caregivers

Heather Sandison  42:46  Personal lifestyle choices

 #Alzheimers #marama #drheathersandison  #wellness  #Ketones #lifestylemedicine  #ketosis #biohacking  #RobertLufkinMD  #sandison #dementia #prevention





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Robert Lufkin 0:00
Welcome back to the health longevity secret show and I’m your host, Dr. Robert Lufkin. There are now programs that can stop the progression of Alzheimer’s disease. What can we learn about how to prevent the disease from these programs? Today we speak with Dr. Heather Sandison, who is the founder and medical director of North County natural medicine, and the founder of Marama. Marama provides the space food staff amenities and experience to implement the lifestyle changes necessary for all timers patients to return to independent living. Dr. Sandison specializes in neurocognitive medicine and neuro hacking. She has been trained to specifically address imbalances that affect the brain including autism, depression, anxiety and Alzheimer’s. She has trained with Dr. Dale Bredesen, Dr. Neil Nathan, Dr. Phil walls, and Dr. Richie Shoemaker. She earned her naturopathic doctorate at bestir University in Seattle, Washington. She currently serves on the Medical Advisory Board of the neuro hacker collective and as a regular host of the collective insights podcast. And now, please enjoy this interview with Dr. Heather Sandison.

Heather, welcome to the show.

Heather Sandison 1:23
Thank you so much for having me.

Robert Lufkin 1:25
It’s so great to have you here. I’m, I’m so excited to hear about the great work you’re doing. I think I share your vision of a world without dementia. And and before we talk about exactly how we go about doing that, to accomplish that. Maybe you could take a moment and tell us how you came to be so interested in this fascinating area?

Heather Sandison 1:55
Yeah, so personally, I spent a lot of my youth and teens and early 20s traveling around the world. And what I noticed was that people who were sick, were not engaged in their communities, right? They were running around a doctor’s visits. They were they were in pain, they were distracted by the illness that they had, right? Oh, a sick man, one wishes to be healthy. And those people who were healthy, they were they were vibrant, they were engaged, they were creating solutions in their communities. And so that really inspired me to become a doctor, I wanted to be that person who could help support people, so that they could come up with the solutions that the world needs, right, and to reduce suffering really to reduce suffering in the world. Then, in 2017, several years after I’d finished training in naturopathic medicine, I, you know, always intrigued by a challenge. And I had heard over and over again, but certainly well meaning instructors in school that to tell someone that they could reverse dementia, or that there was anything you could do about Alzheimer’s was really like negligent and to give them false hope that it would be kind of cruel. So when I was at a conference, and I saw Dr. Bredesen give a presentation about his approach, I was scratching my head going, huh, this makes sense. There’s a lot of common sense that he’s presenting here. And knowing functional medicine, naturopathic medicine, I was like, Okay, he’s onto something. But I don’t quite believe it yet, because I haven’t seen it work. So I went to his training. And soon after I came back to my clinic, and Linda showed that. So Linda showed up with her husband, and she came into my office. She she’s just a buoyant, lovely, smiling human. She had loud accessories and bright clothes. And you could just tell that she was this, this force to be reckoned with this personality. Yet, she only had yes and no answers. She didn’t couldn’t string together a full sentence. When I asked her a question, like, What did you have for dinner last night? Or do you have a bowel movement every day? She you could see the gears in her head turning. And yet by the time she was able to find the words, she had forgotten what the question was, it was really heartbreaking to watch. Her husband just was very desperate to you know, of course, he loved her. She was a very lovable woman, you could tell this right off the bat. And he was just desperate to do anything to help. You could see her health rating had been affected and her MOCA score, the Montreal cognitive assessment, which is a score out of 3026 have been relatively normal. She was a to essentially very, very close to the most severe that we can measure and, and almost nonverbal. So I saw her six weeks later, and they did everything that I had asked they moved out of a multi bedroom, they started going ballroom dancing, they completely changed. She went and had all of her amalgams removed in her Her mouth, she also started on all of the supplements, the hormone supplementation, the hormone replacement, everything that we could think of from this bredeson perspective, she started. And just six weeks later, her MOCA score was a seven out of 30. And she was putting together complete sentences. She was I had to laugh, I actually cried. I had, she was bickering with her husband about something that had happened on the drive to see me. And she her handwriting had had, I don’t know if it had reverted to normal, but it had definitely completely transformed. And when I saw what was possible for Linda, I’m sure like you, how could I do anything else with my life, right? There were so many people, I realized, so many people were suffering unnecessarily, if we could that quickly take someone with disease, that severe than what was possible for people who were just at the beginning stages of dementia, either asymptomatic or early on in the progression of this horrible, awful disease. And so that’s really, when I saw that I, I changed everything I did in my practice. And I started focusing primarily on dementia, and really shifting this narrative so that people can get access to the information that we know right now that can prevent and reverse this disease.

Robert Lufkin 6:25
I’m really looking forward to getting into that details about your program, and specifically how you do it. But before we do that, maybe let’s take a moment. And in this program, today, we’re hearing from a number of different speakers, all experts like yourself in Alzheimer’s disease, and they all have a slightly different view of the disease. So maybe you could just tell us, what is Alzheimer’s disease to you? How do you look at how do you look at that disease?

Heather Sandison 6:54
Yeah, so there’s a number of factors, right? In conventional medicine, we we put these labels, and they’re often Latin terms and fancy words, and we call it a diagnosis. Right. And we, we give it a name, and there are great diagnosticians out there, the concern is when there’s no explanation or understanding of the etiology, or the why. And with dementia, like many other diseases, we put one name on something that has multiple why’s, and often those y’s are not mutually exclusive. So you might have three or four things that have predisposed you or, or precipitated this disease process. Or you might have one or two. So I definitely very closely follow Dr. Bredesen approach and my the mental model that the medical model that I use for complex chronic disease and have for many years overlaps significantly with his. So I’m looking for toxic burden when I think about what the causal root the root cause of the disease process, I’m thinking, you know, what affects the cellular level. And this is really true for all complex chronic disease. However, in this case, of course, it’s applied to dementia. So toxicity, if there’s imbalance and really imbalance at any level, right, too much too little, in the wrong place, or at the wrong time. This can be hormones, but it can be toxins, are there too many too little in the wrong place? Or at the wrong time? Are there nutrients? Are there nutrients, getting to the right places at the right, right time in the right amounts? This is very clear, right? If you don’t get enough vitamin C, you end up with scurvy. If you get too much sugar, you end up with diabetes. Now this can also help it happen at a more functional level with methyl b 12, or many other vitamin D, many other nutrients that we know have an impact on brain function. So toxins, nutrients structure. So this comes from, you know, are we getting enough oxygen to our brain at night? Is there some issue with our airway? Have we been hit over the head with a baseball bat, right? Like we can have structural issues at a macro level, the type of thing that you look at on you’re on the MRI, those things are so essential to understanding because structural issues can directly impact the amount of inflammation in the brain. And that can lead to this disease process or triggering the this disease process. Also, structure at a genetic level, right at a molecular level. If you have a Bui, a PP, there are a handful of known genetic abnormalities that can predispose to the onset of dementia, either late stage or later in life or earlier in life. And understanding these we can start to mitigate some of that risk. We can work a little harder than our neighbor or a spouse who has different genetics so that we can prevent this from happening. So we have toxins nutrients, structure. Stress, we all know how estate, right? Right? When we’re under stress, we don’t remember. It’s this shows up very clearly. And I’ve talked, I’ve spoken to many, many patients who have go through a divorce or a spouse or a parent dies. And in that time, they can think back and go, that’s when this all started, there was a lot of stress. And so mitigating that. Also, early childhood traumas can change the way our brains form. And so where were we kind of start where baseline starts, and how much stress how much cortisol is produced? All of these stress hormones that can negatively impact our cognitive function, of course, sleep. So are we getting those foundational pieces, right, we can have too little exercise, which is a good stressor. So do we have too much of the bad stressors? Or do we have too little of those good stressors, we also need that cognitive stress, right? We want to stay engaged, we want to stay challenged, we really want to lean into those things that are most challenging. So if you hate math, go work with some numbers. If you don’t like words, it go do crosswords and word find you leaning into those areas of weakness, or how we can really stimulate that new nerve neurogenesis. And then the last thing is infections. And with dementia, there are three that we know a bit more about than some of the others, there’s there may be more that you hear from other experts about, but certainly patients of Alice which can be found in the mouth, and then the line, spyera, keetsa, borrelia, burgdorferi, and then the herpes simplex viruses. So those three in particular, we want to be relatively aggressive about treating, treating them early on, and making sure they don’t get out of control. So going to I recommend a biological dentist, or at least a whole health dentist, who can identify if there is an abscess, or, you know, some sort of infection in the mouth really, really, really important. Because that directly can create both cardiovascular risk and inflammation as well as inflammation in the brain. And of course, those go hand in hand. Because structurally, we need to be able to get plenty of oxygen and nutrient delivery, delivery to the brain. But also we need to be able to get things out. And so if there’s inflammation in the vasculature, especially at the capillary beds, that microvasculature this can be have a really big impact on cognitive function. So my my mental model of dementia and how you get it, yes, beta amyloid plaques are an issue. And however, you know, we don’t, I think there’s not a full appreciation. But that’s not the only issue, right? We know that if you just get rid of beta amyloid plaques, you don’t get a reversal of dementia, you actually get often a worsening of cognitive decline, which is the opposite of what we want. We also know that there are many people who live to be centenarians over 100 years old. And when we look at their brains, when they have cognitive decline, and when they don’t, they’re still amyloid plaques, and tau protein sometimes so we know that this protein misfolding, and the plaques and tangles, this absolutely has an impact and is part of the picture, but it’s not the full explanation.

Robert Lufkin 13:24
Oh, yeah, that’s such good information there. The I love the idea, your concept about the way that we the way that we conceptualize a disease and think about it, and just actually what a disease is, and, for example, Alzheimer’s disease is associated with beta amyloid in some patients, but not all patients. And it may or may not be causal. And the evidence is, is in a lot of patients looking like it is and then there and we need instead to go deeper to things like infection or bio toxins or, or nutrients or, you know, all of those things. It sort of reminds me of the way the thinking about heart attacks has evolved. acute myocardial infarction, a heart attack, back in the you know, in the 1950s or so, when a patient had a heart attack, they came in with chest pain, and they were admitted to the hospital, and they were given painkillers to make the pain go away. And then they were supported with, you know, for a read news or things, but that was the treatment of the heart attack. And then people began to understand that, well, it’s actually narrowing the blood vessels and the technology evolved were both surgery and with intervention to put stamps in or replace the blood vessels and that’s still done today. Now for a heart attack. If a patient gets a heart attack, they’ll they’ll get the painkillers but then they’ll also get stents to relieve the blood flow the oxygen to the heart, but To your point, the problem is, that’s really not the cause of the disease. And what people are finding is that you put stamps in or you put you, you do bypass graft blood vessels, and the disease continues the clot, the clogging of the arteries, the plaques recur. And so the disease really is much deeper, like you’re saying, and to conceptualize it as merely a pain in the chest or, or even a narrowing of the blood vessels misses the underlying what appears to be for so many of these chronic diseases, including Alzheimer’s, you know, metabolic dysfunction, inflammation, due to a number of causes, as you elucidated there, it’s it’s fascinating. One thing I always, always wonder about with Alzheimer’s disease, it’s like so many of the other chronic diseases that we’re now facing with stroke, a certain forms of cancer, and hypertension, dyslipidemia, they’re all related to underlying underlying problems. Yet, we’ve come up with some solutions for treating the symptoms, you know, the bypass graft for the heart attack or hypertension, we, we give blood pressure medicines, but neither of those, of course, treat the underlying metabolic cause. Almost all of those chronic conditions can be treated with something but Alzheimer’s disease, conventional medicine has failed to come up with any, any drug, at least FDA approved drug that that reverses symptoms, the best they can do is, as we know, it’s just slow down symptoms, which is which slow down progression rather, which is really sad. And this is despite, you know, some of the best minds in you know, in health care thinking about this and essentially unlimited amounts of money for the last 30 years being spent on this. So what is it about Alzheimer’s disease? Do you think unlike, you know, cancer, or stroke or a heart attack, where at least we have some stopgap things, but all timers, aside from the lifestyle things we’re going to talk about now, which are revolutionary, but conventional medicine is really drawing a blank on that on Alzheimer’s disease and being completely ineffective?

Heather Sandison 17:27
Yeah, Rob, you know, this conversation, it makes me want to cry and rip my hair out and, and then just work harder, right? Because there are so many people who are suffering and really the demographic shifts, right, now we have to find a solution, we don’t have a choice because Alzheimer’s with the rate increasing with with our population aging, this will bankrupt us. And also it’s just not fair, right? Because there are seniors, they are put in homes where they’re parked in front of TVs, and they’re fed cake and cookies, like the exact opposite what’s what’s good for their brains. And we know enough to help these people to prevent disease and bring them back into society where they can continue contributing to the next generations, they can be part of the fabric of our world. And the, you know, what? Why is modern medicine not helping with this? Why can’t we find a band aid? Well, when they miss the mark, they’re totally distracted by beta amyloid plaques, right? Like, it just doesn’t work. And so and then also the, you know, all of it is the structure of how things are set up? How does the pharmaceutical company make money, it’s a single molecule that they can patent, that probably doesn’t reverse disease, because then you don’t make money for very long, right? It needs to, like delay progression, or be something that people stay on forever, so that they can make money forever. So the whole you know, I don’t want to get too fired up here. That’s not the point. This is about being hopeful. Um, but, you know, the whole model is just doesn’t serve anyone. Right? It just keeps people sick. And when, when we start having these conversations about, like, Where’s the data? Where’s this? Where’s that? You’re, you know, if people who don’t value what we’re doing, um, well, then why? Why are so many people sick? If what yours did you’re doing is helping and working? Why is everybody sick? And why are we spending so much money and so much time and so many resources, we need to change the model. And so you know, that that’s the goal here. And that’s, you know, I try to focus more on that, than looking backwards or even even trying to change opinions that are stuck. And I’m just more I’m really effective focus on the people. There’s plenty of them who are looking for solutions and who are willing to do the work because I think that’s the other thing where you get resistance to this model is it requires engagement, it requires work, you’ve got to change your diet, you’ve got to exercise. You’ve got to challenge your brain. You need to swallow some stuff. supplements, usually, you need to do things regularly, this has to become the habit that lifestyle. And conventional medicine is like No, just keep doing what you’re doing and take this pill. Right. And so the I think also, because conventional medicine has struggled for so long to get results in dementia, the expectation has shifted. So that success in dementia is just reducing the rate of decline, which is not okay. That is not okay. And I think like from a humanitarian perspective, this is an awful disease. People are suffering and not just that human that has dementia, but everyone around them who’s caring for them their loved ones, and why would you prolong that process? I mean, that’s just cruel. And so when we think about what adds value here, I think we need to change the, the language we want is reversal. What we need is prevention, I firmly believe with what I’ve seen clinically, with what I’ve seen it Marama, Alzheimer’s is optional, no one in my generation needs to get Alzheimer’s, or very, very, very few. And what we need to do is what we do to treat it, but before it even happens.

Robert Lufkin 21:13
So so for prevention, it’s basically it’s the same principles that you use that Marama and just applying them in, in people before they have the cognitive impairment. Now, as I understand, too, that mild cognitive impairment can be a very actually is the first sign to diagnose Alzheimer’s disease for most patients, but it’s actually a late sign in the progression of disease. And that number of people showing with Mr. Or glucose metabolism in the brain with PET scans, or other sensitive markers, that kind of like diabetes, and like so many of these other chronic diseases, that Alzheimers actually is present for decades, two to three decades, even before the mild cognitive impairment. So what you’re saying is, is when they get the mild cognitive impairment, they they really, it’s, it’s relatively late in the game. And the best thing is to catch it earlier. Right?

Heather Sandison 22:16
Yeah, absolutely. So I’m excited. I do get excited about anybody sort of in the realm of testing and really having a or having a clear test that says, yes, you have predisposition to going in that direction, so that people can sometimes seen that lab marker is very motivating, right? It’s in black and white, you can’t deny it. Whereas if you kind of talk yourself out of Oh, this is just a senior moment, or I was just that day, and oh, it’s not real. However, I think you brought up just such a a really, really important point. And Dr. Bredesen says this over and over. So if you’ve heard it twice like this, this is an important one to put in your brain. mild cognitive impairment is a complete misnomer. It is not mild, that is essentially late stage. This is, you know, very progressive dementia, and are late stage. Alzheimer’s is like in stage Alzheimer’s. But so saying that you have mild cognitive impairment is like telling somebody they have metastatic cancer, they have mild cancer, right? This is not okay. Because what it tells people is, and the other thing and I think it’s almost mostly days so that the doctors feelings aren’t hurt, right? Because there’s a mild cognitive impairment because there’s nothing they can do. Right? They say go home, come back in six or 12 months. And there’s really nothing else that we can do to help and so if they call it mild, like it feels a little less depressing.

Robert Lufkin 23:45
But I mean, it’s gonna get worse.

Heather Sandison 23:49
And, and but that’s not the reality is, there’s so much you know, right now, we don’t have to make it over complicated and wait for more science. Of course, we always want more science. We’re doing a clinical trial in my my clinic practice. So Sarah, right now, we’ve recruited 25 participants, and you’ve partnered with us to see what can happen in six months, if we do aggressive intervention, what can happen in those six months, and then at the end of six months, we let them decide if they want to either stay on the protocol, or we have one patient, he’s like, I’m going to Mexico to drink margaritas on the beach. And we are we support whatever the decision is from six to 12 months, but then in 12 months, we collect more data so that what we can answer is, alright, if you continue the protocols, you get even increased cognitive, you know, do you regain more function? Or if you fall off a bit, do you think kind of go back to the expected progression of disease or do you know retain some of the benefits? assuming we’re getting benefits? You know, we always want to have a critical mind and a scientific mind looking at these products. Cause and what we’re doing. What I feel strongly about, and I passionately believe, and have seen over and over is that we know enough today to start. These things are common sense, it’s a better diet, it’s more exercise, it’s prioritizing sleep and treating sleep apnea going to the dentist and getting the right nutrients. And my job as a clinician, as a researcher, is to make sure that we’re always getting a little bit better, we’re always doing a better job. And if there’s a way to make the protocol better, less expensive, more accessible than we are, we’re, we’re always pushing that. And Dr. Bredesen is, you know, so supportive of me personally, but also everyone kind of in this community. And he’s always asking like, hey, what, you know, who’s not getting better? Because maybe not that we’re excited and happy about that. But like one thing, there’s an answer, there’s something there that we can find out that’s going to help the next 10 people who show up who maybe have the same issue that we haven’t identified yet. So we’re always looking for what we’re missing. And we have enough to get started right now.

Robert Lufkin 26:09
Yeah, no, I love that you’re doing the you’re combining the science and, and doing doing the scientific studies as part of the work that you’re doing at Marama. And, and I mean, the great thing about science, hopefully, you know, unlike, unlike politics or religion is that when confronted with enough evidence that people can change their view, and this is a way to change the opinion of the scientific, the medical community that that a large number of them, as you pointed out, are not are not open to this and are not not looking at it. So it’s, it’s great that you’re doing that I’m, I’m so happy and how long till the results are going to be published. It’s still work, it’s working progress, but when can we? When can we start talking about fine talking about findings? I know

Heather Sandison 27:02
I can’t wait. Um, so he will have all of our data collected by the third of January, all of our six month data collected by the third of January. And so quarter one, quarter two of so like spring? Probably of 2022. We hope to have a paper out there.

Robert Lufkin 27:19
Oh, that’s great. I mean, it’s, it’s so exciting to see so many of these papers, we just talked with Matthew Phillips is a neurologist who did a prospective randomized crossover, partially blinded study of ketogenic diets for Alzheimer’s patients, and and they showed very positive results. And it was a controlled study. So you know, more and more things are getting into the getting into the literature here. Let me let me back up a little bit. You touched on some interesting points about about prevention, let’s say, I guess, first of all, we want to identify the risk. And then And then next kind of the steps to take so if I come in to you, how do I how do I evaluate my risk for for Alzheimer’s disease? What are the things that I need to pay attention to? Or look at?

Heather Sandison 28:13
Really good question. So we, you know, everything that comes into our bodies, and whether it’s media and stress, or foods, or exhaust fumes, to fade, all of these things that are coming into our bodies, it was literally what makes up who we are. And so we spend about 90 minutes with patients on their first encounter with us so that we can collect all of that information and dig into things that a lot of people don’t realize are related to the cognitive function. And then we also do a lot of testing so I’m a data person and, you know, researcher, and I want to know, you know, even if you don’t know that you were exposed to mold. I want to know if there if you’ve accumulated mycotoxins, even if you don’t realize that you maybe ate too much fish, you may have, you know, accumulated Mercury, which is a known neurotoxin. So we want to go through and usually on that initial visit, we want to do the testing so that we can even just check boxes, maybe heavy metals, I had a patient yesterday, he had no heavy metals, he’s in his 80s. And he’s got none of them. And I was like, what a Ruby, if we can just check that box and move on. We don’t have to worry about that. And so which we’re trying to fill in that model, are there toxins and I think of toxins in three flavors, chemical toxins, bio toxins, or mycotoxins that are a result of mold exposure, and then our heavy metals. So we want to know about all those those are the ones we can measure. We can’t measure all of them. But we mentioned what we can and usually there’s a pattern that shows up. I will say that the I would probably close to 199% of my dementia patients, particularly the older patients have some degree of toxicity, right? It’s there if you look and now it’s a lifetime of accumulation. Right. So that makes some sense. And we live in a relatively toxic world. But we want to make the choices that we can we can avoid everything. But where we can make choices to mitigate that risk we do. So we measure toxicity, we measure the nutrients, we measure the infectious burden. And we measure cortisol and other markers, sex hormone binding globulin, globulin, cortisol, even reverse t three can be associated with stress levels. So we’re trying to triangulate and get a sense of how big of an impact stress is having using the metrics that we have. And then we, you know, imaging is so helpful for structural issues and infectious is used. So we’re looking to gather as much information about what might put someone at risk if the if we’re in a prevention stage, and what might have gotten in there. If we’re in a treatment phase.

Robert Lufkin 30:48
Yeah, I want to talk about Marama in a second, and how how you treat the patients there who actually have Alzheimer’s disease. But just to complete this, this thought, as a, as someone interested in prevention, I do the risk assessment, then I obviously wouldn’t come to Marama, which is residential, but I would what, what would I do at home? What can I do for prevention at home?

Heather Sandison 31:13
I’m so glad you asked. And I’m just going to I know you’re talking to Dr. Bredesen, but this is the handbook for what you do at home the end of Alzheimer’s program. So he’s just done. You know, I’m shamelessly riding his coattails, he has done so much to create a program to publish this to organize it so that people can do this at home. And I’ll tell you, I see patients in my in my clinical practice who they’ve taken the books, they’ve done everything they can at home, and they’re better. And they want that edge, they want even more. So they want to do all the testing and they want to understand, okay, is there something I’m missing so that I can get even better. And that’s just such a privilege. I love seeing patients like that, because I already know that they’re there on it, and they’re doing it and I love supporting them. So what happened in my practice was as I was kind of creating a reputation around seeing dementia patients, I had people calling saying, Hey, I know you treat this, but where can I send my loved one, I really I can’t do it. Often, the daughter, and she’s my age are a little older, and she’s got kids of her own. She’s got a full time job. She’s got dogs and cats and a house to manage. And she has an aging parent who needs help. And she wants she’s aware of Dr. Bredesen protocol and wants to be able to do it. But it’s a lot of work. And so they were I had several people calling to ask where Who do you trust? Where can I send my loved one. So I started looking around, and there was no place to send people that I felt really confident in. And there were a couple places, but they were sort of doing a halfway job, there wasn’t organic food, there wasn’t a ketogenic diet available. And they maybe had access to a medicine doctor down the street. But it wasn’t the lifestyle, which I would almost say, if you’re not going to do the lifestyle piece, it’s not worth spending the money with the doctor, you may as well. I don’t want to tell anyone to give up ever, because we’ve seen phenomenal transformations of people who, you know, even I wasn’t hopeful about. So I never want to tell anyone not to do it. But you really the 80% is the lifestyle. And so when I started looking into, you know, how can we make it easier for people to live this lifestyle? And I saw that there wasn’t really an option. I thought to myself, well, how hard could it be? Let’s just create one. And then of course, we open to the week before the world shut down with COVID, I opened a nursing home, which I just have to laugh about, because that’s what the universe does. But it’s all been a blessing. No one at Marama, no resident at Rama got COVID we had to five staff get COVID, they all did really well and have fully recovered. But we were able to keep COVID out of the building. And so that that felt like a win because we know how detrimental that can be to cognitive function. So certainly in protecting cognitive function, we need to protect our residents from COVID. So

Marama is right now we’re growing. And right now, really with what we’re asking, you know, we’re the only place in the world really doing this and we’re only in San Diego. So to come for prevention, we certainly would prefer that. So we’re trying to attract people who have mochas, again, these Montreal cognitive assessments that are like in the 2080s however, we have a woman who has a mocha of zero who’s there and she’s she’s and speaking in full sentences. I mean, it’s just really phenomenal. What the transformation we’ve seen with her she got on the bike yesterday for the first time. So she’s Making, she’s making progress. You know, she’s not like Linda, who I talked about at the beginning, she’s not going back to work. But her experience of life, she can tell us if she’s cold, she can tell us when she’s hungry, she can engage and and she’s not angry and frustrated, because she can’t express herself anymore. So her experience of life is better and different. Now, prevention, I know is the focus of us here today. And prevention is so much less expensive, it’s so much less effort, it happens so much faster. And what I would love, I was having this conversation with someone recently, it’s like I would love if when people retire their their spouse, or their friend or somebody goes with them, and if they go to some Retreat Center for six months, and they learn to live this lifestyle, that would be the best prevention is an immersive experience, kind of like Miranda, but before the onset of a disease. And then you take this home with you. So that kind of as you transition from, like the working life to retirement, you have a handbook, you have a playbook for like, Okay, this is how I really put my health first, and I prevent disease. So that those senior years that sensitive our life isn’t spent running from doctor to doctor, you know, in pain, inflamed, always, like coming up against the next health hurdle, you can actually live it and enjoy it.

Robert Lufkin 36:26
Yeah, yeah, I mean, to underscore what you said, and put that in perspective, though, how just unique and special Marama is, and what you’re able to do to actually treat Alzheimer’s disease and reverse it. When my mom got dementia, sadly, a few years ago, before, places like Marama, or even the new understanding we have of it, she was admitted to a nursing home for a while. And then she is as her memory decline. She went to quote a memory care unit, which was basically nothing, nothing really was done. And and she eventually declined and passed away. But sadly, that’s pretty much the standard of care today for so many people and a place like Marama is is really the exception. But as you say it’s it’s it’s nearly unique in the world at what you’re doing. So it’s so important to get this this message out there. And you mentioned it’s in San Diego. And patients can can travel there to be to be residential care. How can patients access your work from elsewhere? What, if anything with telemedicine or what how would? What are the programs do you have?

Heather Sandison 37:47
Yeah, great question. So we actually are in the process of building out a course for caregivers so that caregivers understand how to best implement this at home and they get a little bit more support. With that. Dr. Bredesen has done a really great job he has through Apollo, you know, he trains and recode he trains providers, so anyone from health coaches to physicians, and a lot of the the, again, the daughters of some of the patients I have have taken that because they’re a psychiatrist or psychologist or, you know, they’re kind of peripherally a dentist, a health care provider, and so they have access to it. And what we wanted to do that really dives deep into like the labs and all of the medical pieces. And so what we hope will offer some value is to just show what we do with our residents day to day from a caregiving perspective, so that everyone has the tools, you know, if your loved one is excited to watch TV, like it rots your brain, right, like don’t do that. So what are some alternatives that you can sort of redirect? What’s the language to you give people a bit of a script, so that it doesn’t feel like much effort to to redirect them towards the brain game or something stimulating? Now all of this does take time and whoever Rama, we have the luxury, we’re not someone’s daughter or grandchild. So you know, we don’t read into things and think oh, he’s saying that because of something that happened 20 years ago. Nothing is personal, because everyone’s kind of new to us. And also the caregivers are just so well trained, and they’re so compassionate. And they just, they inspire me every day, the work that they’re doing. They are really making miracles happen over there. So yeah, we’re excited to expand we are again, we are growing, we’re in San Diego and our residents have come from all over the country. We have someone from South Africa trying to figure out a visa right now we’re not really sure exactly what how quickly that’ll all happen especially just in the day and age we are in. But we have people who’ve come from Georgia, Florida, South and North Carolina, from Manhattan, from Northern California, from Hawaii, from Ohio, from Texas. So we have people coming from all over the country. They come Rama and we recommend at least a six month minimum. It takes like you said like these are, this is a disease process that is years decades in the making. And so it takes a while to slow it down, and then turn it around and then get going in the other direction. Even the fact that we expect, you know, this all happened in six months is kind of miraculous, right? It’s kind of it’s a big ask. And yet we see it, we see it happening. So we want to get that that ship turned around going the other direction. And minimum six months is what we asked for it also there’s an adjustment period. So for anyone doing, integrating this Bredesen protocol at home, I stick with it, I just highly recommend like there’s a bit of a hump to get over, where it can feel uncomfortable as someone is detoxing from sugar, detoxing from TV, maybe alcohol, and it’s worth it to kind of get up over that hump. So as people come into Marama, you know, they’re adjusting to a new location, a new a new space. And that can take about two, three weeks, four weeks sometimes to kind of get up over that hump, we only invite one new resident per month, because we we don’t want you know, the the culture can shift really quickly if we have two or three people doing that at a time. And so we just have 12 residents, and we want you know, it’s really it’s so fun to watch because the residents who have been there for a while, they, they really like rally around that new person and welcome them. We had one resident the other day, he was telling me, I want to create a preamble is what he calls it, I think he was looking for the word, but the word he came up with was preamble and just to tell people, you know, just stick with it just don’t criticize because you know, when someone’s uncomfortable, they they’re going to push back a little bit. But it was great. If you think I see it works, I see it works, they just need to do it. And so it was really neat to hear him kind of give that testimonial. And they all watch each other get better. And that social engagement and support is a big part of the healing. Now you can do this at home, I’d love to hear that people are creating like Bredesen groups in different cities where they can support each other. And like senior centers now that those are opening again, having support groups and senior centers where people are trading recipes and encouraging each other and uniting and getting that social connection and how good that is for our brains.

Robert Lufkin 42:31
Yeah, that that sense of community is key. Well as a as an expert in Alzheimer’s disease, as well as lifestyle. I’d love to hear if you don’t mind your thoughts on what you do yourself for your own personal lifestyle choices.

Heather Sandison 42:46
Yeah, of course. So, you know, I went to naturopathic school, and that was essentially an education and taking good care of myself and prioritizing. So I go to Pilates three times a week I went this morning, it was wonderful, it feels so good. Pilates is really great for the brain. This is Sarah McHugh. And I think you may have interviewed her, maybe you are but she created an app called genius gems. And she was the one who told me about this little nugget that I think is so important. If you’re stimulating your brain at the same time that you’re getting movement and exercise you actually get exponential benefit for the brain. And so Pilates is you’re sort of anticipating the next move and you’re listening very closely to the instructor to coordinate your movement and your left foot right foot, you know, you’ve got to be very present. So it’s almost like a meditation where you’re fully present and you’re connecting those dots in your brain as you do the movement. So I hope they’re approved but that that’s one of the things that I’m committed to I also wake up and drink 32 ounces of very clean filtered filter but it’s spring water it’s vague. I know it’s non toxic so I avoid tap water I think that that’s important particularly in something Southern California, we have good water for the Marama residents for cooking and drinking. So I wake up and drink 32 ounces of water stay hydrated and I also i do what i love i stimulate and challenge my brain I’m addicted to growth and progress and so always just on that edge I think it certainly for me personally feels good. And my I have a she’s almost three, almost three year old daughter and so her brain you know of course I’m a mom with the brain on my mind and the development of her little brain. And so she is learning Spanish as well as English. She’s in a Spanish Immersion program, and art and music and these play lots of time outside. And so in terms of her brain, and then of course I get the benefits because I get to go play with her outside whenever I’m not working. And so the you know, those are the things I think personally that stand out for me right now. My mom is also on this campaign of senior moments. And so we got her amalgams out, got her on a program and she doesn’t complain about them anymore.

Robert Lufkin 45:11
That’s That’s wonderful. How, how can people follow you on social media? We’re gonna put links down below. But for anyone who’s listening to an audio only version, maybe you could tell them now.

Heather Sandison 45:22
Absolutely. Thanks for asking. So Marama is our website. And then we’re on Twitter, Facebook, Instagram is Marama experience. And then it’s so sorry. So l c, e r e, so sorry, is the clinic that I founded, where we’re doing a lot of the medical side of things. This is in North County, San Diego, and it’s so And then I think it’s so scary health or so scary. On Twitter, LinkedIn, Facebook, all the Instagram, all of them, they’re out there.

Robert Lufkin 45:57
Great. Well, thank you so much, Heather. It’s been wonderful to spend an hour getting to know you better, and hearing about all the great work you’re doing and I can’t wait until the scientific papers come out as well, too. And we can we can hear how things are turning out there. But again, thanks. Thanks for being with us. And we really appreciate it.

Heather Sandison 46:18
Rob such a pleasure to be here. It’s such a privilege to both be here and to be part of this community and to be doing this work. So appreciate you.

Unknown Speaker 46:27
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Ketones and ketosis is everywhere in the news. What are ketone bodies, why are they so good for us and how do we measure them?
Our guest today is Jim Howard who happens to be the CEO of biomarker-based startup Readout Health. They make Biosense, the first clinical-grade, handheld device that measures nutritional ketosis for chronic disease and longevity/wellness focused consumers. He is a 27-year digital health executive with an MBA from University of Missouri-Saint Louis.

Take away points:

What are the three ketone bodies and the three general ways to detect them?
Three Ketone bodies are produced as a by‐product of fat metabolism. When the liver metabolizes circulating free fatty acids, they are transformed into acetyl‐CoA, a molecule used in the production of energy. Depending on the glucose level, acetyl‐CoA can be diverted to produce acetoacetate, the first of three ketone bodies. From acetoacetate, two other ketone bodies, β‐hydroxybutyrate and acetone, are produced by enzymatic degradation or spontaneous decarboxylation, respectively.

All three ketone bodies circulate in the bloodstream. Acetone, because of its small size, diffuses into the lung and appears in the exhaled breath. The devices we will be discussing detect levels of acetone from this process.

Deep lung measurement.

Biosense Breath Ketone Monitor -Use the code Lufkin20 for a $20 discount at 





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